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Abstract: A 6-year-old boy was brought to our hospital by his parents because he presented with an itchy, red, swollen eye with white discharge causing crying. Through communication, physical examination and cytological conjunctival scraping, it was clear that the child had spring keratoconjunctivitis. After obtaining the family’s consent, the child was treated with emetine fumarate eye drops and diclofenac sodium eye drops. After 1 week of medication, the eye returned to normal, and the symptoms of eye itching, redness, and abnormal discharge gradually decreased and disappeared, and the treatment effect was good.
Basic information】Male, 6 years old
Disease Type】Spring Keratoconjunctivitis
Hospital】The First Affiliated Hospital of Zhengzhou University
Time of consultation】May 2019
Treatment plan】Medication (emmetine fumarate eye drops, diclofenac sodium eye drops)
Treatment period】1 week of combined medication, followed by discomfort
【Treatment effect】The redness and swelling of the eyes and abnormal discharge gradually improved and disappeared
I. Initial consultation
A pair of parents came to our hospital because their 6-year-old child’s eyes were uncomfortable and he cried and said he had itchy eyes. They thought they had touched his eyes with their dirty hands, but after washing, they still had itchy and red eyes, and white mucousy filaments appeared inside his eyes. The child’s parents thought that the child had also had itchy, red eyes after touching a stray cat last spring, but it was not serious, and the symptoms disappeared over time, so they did not seek systematic medical treatment. However, the previous allergen check revealed an allergy to cat hair, and now with the eye discomfort, his parents began to wonder if the allergy was related to having touched a stray cat. After cleaning the child’s eyes, the examination revealed that the child’s conjunctiva was congested, red and swollen, with paving-stone-like papillary hyperplasia, accompanied by a sticky milky discharge.
II. Treatment history
I determined springtime keratoconjunctivitis by performing a cytologic conjunctival scraping examination on the child, which revealed an elevated eosinophil count of more than 3/high magnification field. After the communication, physical examination, and cytological conjunctival scraping examination confirmed that the child had spring keratoconjunctivitis, I told the child’s parents that the disease was not serious and could be treated with anti-allergy and anti-inflammatory medications, and that there was nothing to worry about. Since the child’s condition was not very serious, I advised him to use eye drops such as emmetine fumarate for anti-allergy treatment and diclofenac sodium for anti-inflammatory treatment. If the treatment was not effective, then glucocorticoids such as tobramycin dexamethasone drops should be used to avoid fungal infections and other adverse consequences after improper use of hormonal drugs, and the child’s parents agreed to the treatment plan.
III. Treatment effect
One week after the eye drops, the child came to the hospital for follow-up, and his parents told me that the child’s eyes were no longer itchy and swollen after using emmetine fumarate eye drops and diclofenac sodium eye drops, and I found that the child’s cornea was no longer congested and the pavement-like papillae had returned to normal. I was happy for the child. I was happy for the child, but I also told the parents that they should go to the hospital for outpatient examination if the child has any more eye discomfort.
IV. Notes
I was very happy to see the child’s symptoms improve, and I told the child and the parents to pay attention to the following aspects.
1. The child needs to pay attention to avoid contact with allergens again in daily life, and the parents need to take care of the child and avoid the child touching cat hair to avoid allergic reactions.
2. The child needs good eye and hand hygiene in daily life, and parents can help by teaching the child that hands need to be washed promptly after contact with dirty things and not to touch the eyes directly to prevent eye infection and eye itching and other uncomfortable symptoms.
3. Do not touch or rub the eyes with your hands after the symptoms of itchy eyes appear, as it is easy to stimulate the eyes and aggravate the symptoms of itchy eyes, you can try to wash the eyes with water or apply ice to relieve the symptoms.
V. Personal insight
In the clinic, more patients wait until the symptoms are severe before going to the hospital for treatment. After the delay in treatment, the disease mostly progresses more after the hospital diagnosis, and some of the diseases may have deteriorated, and the treatment is relatively troublesome and the course of treatment will be extended. Although keratoconjunctivitis is not serious in the spring, it is recommended that patients with similar symptoms go to the hospital as soon as possible to confirm what they are suffering from, as early treatment is more effective and less risky, and can also shorten the course of the disease to a greater extent.